Standard interferon in the treatment of. hepatitis C; response rate in genotypes 2 and 3 from an area in Azad Kashmir, towards north of Pakistan

To assess the response rate and side effect profile of combination therapy with standard interferon alpha 2a and ribavirin in patients with chronic hepatitis C, genotype 2 and 3. Observational study. This study was conducted at Saleem Medical Complex and Maryam Maternity home,Kotli, Azad Kashmir from January 2012 to December 2012. Both male and female patients above 20 years of age with chronic hepatitis C, living in district Kotli Azad Kashmir, not treated previously, were included in the study. Viral load and genotyping were determined before initiation of treatment. Therapy was given with conventional interferon alpha 2a, 3 Million international units subcutaneously on alternate days and ribavirin 400mg tablets twice daily, for 24 weeks. PCR was repeated at the end of treatment and six months later. Clinical and lab monitoring was done at regular intervals and side effect profile was recorded. Out of 150 patients, 30 [20%] were males and 120 [80%] were females. Most of the patients were between 20-50 years of age [83.99%]. End of treatment response was 82% and sustained viral response was 65.33%. Fever was the most common side effect followed by flu like symptoms. All the patients completed the treatment without any dropout. The study showed a good response rate to standard interferon plus low dose ribavirin against genotype 2 and 3, with a favorable side effect profile without any drop out, indicating that it is a suitable treatment option

Frequency of category 1 and category 2 tuberculosis in district Kotli Azad Kashmir

To estimate the frequency of Category 1 and 2 Tuberculosis in area of research. Cross sectional study. This study was a conducted in District Kotli Azad Kashmir from January 2009 to December 2009. This study was conducted with a population of 750,000. Data was collected from all the eight national TB centres in the District Kotli. It included every patient registered there with the diagnosis of tuberculosis including pulmonary and extra pulmonary tuberculosis and sputum smear positive and negative patients. They were classified as category 1 and category 2 according to the standard definitions. Results were given in tabulated form. From a total of 752 patients, 579 [76.99%] were pulmonary and 173 [23%] were extra pulmonary. In pulmonary TB cases, 259 [44.78%] were sputum smear positive [235 [90.73%] of them were category 1 and 24 [9.24%] were category 2]. In 320 [55.26%] sputum smear negative patients, 300 [93.75%] were category 1 and 20 [6.25%] were category 2. All of the extra pulmonary TB cases were category 1 [100%]. As a whole 708 [94.15%] were category 1 and 44 [5.85%] were category 2. In our study frequency of category 2 patients was found to be relatively low. It indicates that the problem of drug resistant tuberculosis is probably low in the area. It also shows the effectiveness of local TB control programme

Prevalence of tuberculosis in Kotli, Azad Kashmir

Tuberculosis is highly prevalent in Pakistan. It is a contagious disease and causes a lot of morbidity and mortality. Its treatment is costly especially for poor countries like Pakistan. But fortunately it is a preventable disease. Objective of this study was to analyse various epidemiological features of tuberculosis in District Kotli, a remote area of Northern Pakistan. This cross sectional study was conducted in District Kotli, Azad Kashmir from January to December 2009. Data was collected from eight national TB centres of District Kotli. It included all the diagnosed cases of tuberculosis, registered there during the study period. Various epidemiological aspects of these patients were analysed. Total number patients registered during the study period were 752. Of these 579 [76.99%] were pulmonary and 173 [23%] were extra-pulmonary tuberculosis [EPT]. Total prevalence of tuberculosis was found to be 100.27 per 100,000. Prevalence of pulmonary TB was 77.2 while that of EPT was 23.07 per 100,000. There were 405 males [53.85%] and 347 females [46.14%]. Most patients were 61-75 years of age [220, 29.25%]. Overall 417 [55.44%] were 46-75 years. Housewives were affected most frequently [324, 43.08%]. Labourers were also commonly involved [40.82%]. All cause mortality was 29 [3.85%]. Mortality due to tuberculosis was 11 [1.04%]. Among pulmonary tuberculosis, 259 [44.78%] were sputum smear positive and 320 [55.26%] were sputum smear negative. In EPT, most frequent was pleural effusion [74, 42%] and least frequent was skin involvement [3, 1.73%]. Prevalence of tuberculosis in Kotli was lower than the overall prevalence in Pakistan. Male to female ratio was lower than that generally observed in Southeast Asia. It was more common in middle to old age population. Frequency was higher in housewives and labourers. Very significant proportion of pulmonary TB was sputum smear positive. Among EPT, pleural effusion was the most common mode of presentation

Frequency of hepatitis C in asymptomatic patients in district headquarters hospital kotli, azad kashmir

Background: Hepatitis C is a common problem in developing world. It can affect a large number of asymptomatic people in whom it may cause serious complications in long run. Moreover, these asymptomatic infected people pose a serious risk for the transmission of infection to healthy population. Objective of this study was to estimate the frequency of Hepatitis C in asymptomatic adult patients attending medical OPD of District Headquarters Hospital Kotli, Azad Kashmir, and to assess the risk factors associated with its transmission. Methods: This was a cross-sectional study that included asymptomatic patients of both genders, aged 15–80 years, attending medical OPD of District Headquarter Hospital Kotli, Azad Kashmir from January to December, 2008. They attended the OPD for problems other than Hepatitis and most of them presented with vague complaints like generalised body aches, tiredness and dyspeptic symptoms. They were randomly tested for Hepatitis C virus [HCV] antibodies by Immunochromatographic kit method. Positive samples for Hepatitis C antibodies were confirmed by third generation ELISA. Those who were confirmed were assessed for the risk factors associated with HCV transmission. Results: The study included 9, 564 patients. Out of them 4, 230 [44.22%] were males and 5, 334 [55.77%] were females. A total of 611 [6.38%] cases were positive fo HCV; 257 [6.08%] were males, and 354 [6.64%] were females. Highest frequency [36%] was found between 21 and 30 years of age, and 60.54% positive patients were 21–40 years old. Blood transfusion was the most common [34.36%] risk factor followed by history of dental procedures [24.54%]. In 27.16% no risk factor could be detected. Conclusion: Frequency of Hepatitis C is quite high in our population. Rate is higher in young adults. It is needed to adopt organised preventive strategies to overcome this problem. Blood transfusion is still the most significant risk factor followed by dental and surgical procedures. Health related procedure

Frequency of hepatitis B in asymptomatic patients of district headquarter hospital Kotli, Azad Kashmir

Hepatitis B is prevalent throughout the world including Pakistan. A large proportion of patients suffering from Hepatitis B may be asymptomatic and can transmit the disease to healthy population. Objectives of this study were to estimate the frequency of Hepatitis B in asymptomatic adult population coming to District Headquarter Hospital Kotli, Azad Kashmir and to determine the risk factors associated with its transmission. This was a cross-sectional study extending from January to December 2008. Subjects were randomly selected from those who attended the medial OPD of DHQ Hospital Kotli, Azad Kashmir for non-Hepatitis related problems. Both males and females between the ages of 15-80 years were included in the study. Blood samples taken from selected subjects were analysed for Hepatitis B surface antigen [HBsAg] by Immunochromatographic kit methods [ICT]. Hepatitis B positive samples were further confirmed by third generation ELIZA. The patients thus confirmed were interrogated for different risk factors associated with transmission of Hepatitis B. A total of 9,564 patients were analysed. Out of them 4230 [44.22%] were males and 5334 [55.77%] were females. Overall 141 [1.47%] patients were positive for HBSAg, 71 [1.68%] males and 70 [1.31%] females. Patients between 21-30 years of age were most commonly effected [35.46%, n=50]. Blood transfusion was the most common risk factor [24.82%, n=35] associated with Hepatitis B transmission followed by dental procedures [14.18%, n=20]. Frequency of Hepatitis B in asymptomatic people in this study was quite high. Blood transfusions and dental procedures were the most common risk factors associated with the transmission of Hepatitis B